2012-06-14-世界卫生组织-An_equity-focused_strategy_to_improve_access_to_essential_treatment_services_for_children_8页_2mb

This WHO/UNICEF Joint Statement emphasizes the implementation of Integrated Community Case Management (iCCM) as an equity-focused strategy to improve access to essential treatment for children under five.

1. Core Strategy: iCCM manages childhood illnesses (pneumonia, diarrhoea, malaria) by training community health workers (CHWs) to diagnose and treat common conditions correctly, especially in remote or underserved areas where facility access is limited.
2. Target Conditions & Treatments: Focuses on three main killers: pneumonia (oral antibiotics), diarrhoea (ORS, zinc), and malaria (ACT if RDT positive).
3. Key Components: Requires training (Clinical skills), consistent supply (child-friendly medicines/doses, diagnostics), supportive supervision, performance monitoring, and costed national plans. The 'gold standard' training package is available online.
4. Effectiveness & Access: Shows CCM can increase treatment coverage for conditions previously relying mainly on facility-based care, reduce mortality, and address equity gaps for the poor.
5. Justification: Current treatment levels are unacceptably low; iCCM directly tackles access barriers, potentially saves millions of lives, and leverages CHWs effectively.
6. Implementation Support: Proposes benchmarks covering eight system components (coordination, costing, human resources, logistics, service delivery, communication, supervision, monitoring). Tools and resources are available online via CCMCentral.com.
7. Conclusion: iCCM is presented as a vital strategy to achieve equity and reduce under-five mortality goals.

The document serves as a guide for countries and partners to scale up iCCM, emphasizing the importance of policy, training, supply chain management, and monitoring.